Evidence map›Paper›PMID 20972678›Full record

ArticleWorld journal of surgery2011

Risk factors and outcomes for anastomotic leakage in colorectal surgery: a single-institution analysis of 1576 patients.

Mark A Boccola, Petra G Buettner, Warren M Rozen, Simon K Siu, Andrew R L Stevenson, Russell Stitz, Yik-Hong Ho

Abstract read
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In one paragraph

Article in World journal of surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Management of anastomotic leak after elective anterior resection for rectal cancer: A systematic review and pooled analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
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  8. External coating of colonic anastomoses: a systematic review.International journal of colorectal disease · 2012
    Pooled it
  9. Prophylactic anastomotic drainage for colorectal surgery.The Cochrane database of systematic reviews · 2004
    Pooled it
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  20. Anastomotic Leak Following Colorectal Surgery.Clinics in colon and rectal surgery · 2026
    Review

28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Mark A BoccolaDiscipline of Surgery, School of Medicine, James Cook University, Townsville, QLD, 4814, Australia.
Petra G Buettner
Warren M Rozen
Simon K Siu
Andrew R L Stevenson
Russell Stitz
Yik-Hong Ho

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnastomotic leakage is associated with high mortality, high reoperation rate, and increased hospital length of stay. Although many studies have examined the risk factors for anastomotic leak, large prospective series that report on long-term survival rates are lacking.

methodsData of 1576 patients who underwent primary resection and anastomosis for colorectal adenocarcinoma at a single institution from 1984 to 2004 were prospectively collected. Anastomotic leaks (LEK) were classified as radiological (RAD), local (LOC), or generalised (GEN). Logistic regression analysis of 21 variables was undertaken. Overall survival, cancer-related survival, and disease-free survival were analysed using the Kaplan-Meier method.

resultsMean age of the patients was 67 years (SD = 12.5) and 834 (52.9%) were male. An LEK was more likely when relatively major gynaecological (tubo-oophorectomy, P = 0.004; hysterectomy, P = 0.006) or urological (total cystectomy, P = 0.014) procedures were performed during the same operative session. Other significant factors were anterior resection (P < 0.001), anastomosis using an intraluminal stapling device (P = 0.005), abdominal drain via laparoscopic port (P = 0.024), postoperative blood transfusion (P < 0.001), primary cancer site at the rectum (P = 0.016), and TNM stage of T2 or higher (P = 0.026). Having an LEK showed significant impact on overall (P = 0.021), cancer-related (P = 0.006), and disease-free (P = 0.001) survival.

conclusionIn this prospective study, advanced tumour stage, distal site, and need for postoperative blood transfusion were associated with increased rates of anastomotic leakage. In addition to their high risk of immediate postoperative morbidity and mortality, both localized and generalized leaks had similarly negative impacts on overall, cancer-related, and disease-free survival.

Indexed as

AgedAnastomotic LeakChi-Square DistributionColorectal NeoplasmsColorectal SurgeryFemaleHumansLength of StayLogistic ModelsMaleMiddle AgedPrognosisProspective StudiesReoperationRisk FactorsSurvival Rate

Identifiers

PMID20972678

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.